A Pediatricians' Raw Experience in Private Independent Medical Practice on the front lines.

Thursday, May 26, 2016

MOC: How the American Board of Pediatrics Failed this Nursing Physician

To the American Board of Pediatrics:

I took and passed my recertification exam in Washington
State last fall and would like to express my sincere gratitude to your
organization for setting up more hoops for pediatricians to jump through under
the guise of helping us stay up-to-date. The first hurdle was the exam application and
the second was the testing day experience, which was one of the most demeaning of
my entire life.Below are my thoughts.

My daughter would be 9 months old and still nursing when I
took the exam.The recertification test duration
is six hours with a 20 minute break for lunch. When I inquired about adequate
time to pump and store milk, your office informed me I was the first and only pediatrician
in the United States to request an accommodation. Consideration for 20 extra minutes required
application as a “disabled” physician.

My “disability” request involved submitting a letter by me
outlining my needs, obtaining a second letter detailing the same from my
Obstetrician, to include his CV, medical license, and credentials. Obviously, this application process was instituted
to discourage anyone from requesting schedule variances.My heart should have been bursting with delight
when you allowed me time to pump milk to feed my daughter.

While swiping our credit cards to fund this atrocity known
as Maintenance of Certification, maybe your group could take a few moments to streamline
your rigid and archaic application process?It is not exactly rocket science or is keeping track of so much money simply
too exhausting?

The morning of the test I left my home at 6:30am in order
to reach the testing site by 10am, which required travel across the Puget Sound
by ferry.Upon arrival, I was allowed
only one small locker for my things with no exceptions for those with additional
necessary medical equipment.My $1200
breast pump had to be placed on top of the bank of lockers with no assurances
it would remain there throughout the testing period.

The staff was unwilling to put it anywhere else for safe
keeping.We were warned not to leave
valuables inside our vehicles, because the testing site was in a high crime
area.Desperate to keep both valuables,
I tried putting the pump motor and my wallet in the locker but to no
avail.

The alternative option was to place the pump inside the
locker and my purse with my credit cards and identification on top. Figuring it
was less likely my breast pump would be stolen; I took my chances and placed my
purse inside the locker.Why couldn’t an
exception be made for storing necessary medical equipment?In light of my “disability”, is that even legal?

The very intensive search process ensued as I presented my
driver license, turned out each and every pocket in my clothing, and was “wanded”
like a common criminal. I have more
sympathy for them now that I have been subjected to such measures.Finally, testing began.Emerging three hours later, I was relieved to
see my breast pump still sitting on top of the bank of lockers.

No room was available for pumping, so I was told to use
the bathroom. I ate lunch, went to the restroom,
and discovered one plug next to the sink.Unable to use the counter with others needing to wash their hands after
using the facilities, I would have to sit on the floor.I returned to the waiting room mulling over how
to resolve this situation.

Finding a plug in the waiting room, I began to set up my
pump and put on my hands-free pumping bra.The room contained about 20 young men waiting to take their truck driver
tests, hairstyling certification exams, and other trade competency assessments.
Horrified, the testing center attendant jumped
up and demanded, “What are you doing?” My answer was, “If you are unable to find a
private room for my activities, this waiting room is going to witness quite a
show.”

Surprisingly, she went to find the site manager and they found
me a more private location.Isn’t there
a federal law that guarantees nursing mothers are provided appropriate accommodations,
with one electrical outlet far enough from a water source to ensure safety from
electrocution?

Basically, I am a hard-working pediatrician with 12 years
of post-high school education and 14 years in practice.By 7:30pm, I returned home feeling beaten down
and humiliated. Why would any physician submit
to this degrading process to “recertify” board competency?It is absolutely unacceptable.

All testing sites should have adequate storage for
required belongings, a testing site should be within 30-60 minutes of our home
or workplace, and in compliance with federal law, adequate facilities should be
available to properly attend to our medical needs.

Many female physicians, including me, postponed their
child bearing in order to complete our educations.I had three children aged 4, 2, and 9 months
when recertifying.These regulations
place undue burden on those of us who have young families.If we are “disabled”, then why are we not accommodated
in compliance with federal standards?

Is the American Board of Pediatrics as callous as they
seem?Maybe individuals on the Board of
Directors did not breastfeed their young children and cannot spare a drop of
empathy for medical needs of fellow physicians?Maybe things would be different if pediatricians could prevent the
American Board of Pediatrics employees from paying their bills and feeding their
children? Wait, we actually could do
that if we refused to comply with your unreasonable demands.Hmmm…

4 comments:

This is horrifying considering that the AAP should be the most supportive of the specialty boards! I can't believe no one has asked for an accommodation before...they are full of it. I'm FP and was thrilled to see that at the annual AAFP conference, they had pumping rooms located conveniently throughout the conference area. It almost (but not quite) made me wish I was pumping again. But I made sure to tell everyone I could how much I appreciated it!

I hope your comments make someone stop and think. And change a few policies.

It was a devastating experience but I hope this helps others move medical organizations forward to change. The AAFP sounds like they are light years ahead of the AAP. My hats are off to the family practice organization for joining the 21st century!